Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-26T20:48:27.579Z Has data issue: false hasContentIssue false

Schizophrenia: update on genetics, cognitive behavioural therapy and early intervention

Published online by Cambridge University Press:  13 June 2014

Brendan D Kelly*
Affiliation:
Department of Psychiatry, Our Lady's Hospital, Navan, Co Meath, Ireland

Abstract

There have been considerable advances in the understanding of schizophrenia in recent years. This educational review paper focuses on three areas of interest and relevance to trainees preparing for the membership examination of the Royal College of Psychiatrists (MRCPsych): (a) recent advances in the genetics of schizophrenia; (b) advances in cognitive behavioural therapy in schizophrenia; and (c) advances in early intervention strategies for schizophrenia. Relevant papers and systematic reviews are discussed, and recommendations for further reading are provided.

Type
Educational Review
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kelly, BD. Investing in the future. Ir J Psychol Med 2004; 21:111CrossRefGoogle ScholarPubMed
2.Jablensky, A. The 100-year epidemiology of schizophrenia. Schizophrenia Res 1997; 28: 111128CrossRefGoogle ScholarPubMed
3.Rudin, E. Zur Verebung and Neuenstehung der Dementia Praecox. Berlin: Springer, 1916Google Scholar
4.Kallmann, FJ. The genetic theory of schizophrenia: An analysis of 691 schizophrenic twin index families. Am J Psychiatry 1946; 103: 309322CrossRefGoogle ScholarPubMed
5.Gottesman, II, Shields, J. Schizophrenia: The Epigenetic Puzzle. Cambridge: Cambridge University Press, 1982Google Scholar
6.Luxemberger, H. Vorlaufiger Bericht uber psychiatrische Serienuntersuchungen an Zwillingen. Zeitschrift fur die gesamte Neurologie und Psychiatrie, 1928; 116: 297326CrossRefGoogle Scholar
7.Rosanoff, AL, Handy, LM, Plesset, IR, Brush, S. The etiology of so-called schizophrenic psychoses with special reference to their occurrence in twins. Am J Psychiatry 1934; 91: 247286CrossRefGoogle Scholar
8.Essen-Moller, E. Psychiatrische Unterschungen an einer Serie von Zwillingen. Acta Psychiatrica et Neurologica Scandinavica 1941; Suppl 23Google Scholar
9.Shields, J, Gottesman, II, Slater, E. Kallmann's 1946 schizophrenic twin study in the light of new information. Acta Psychiatrica Scand 1967; 43: 385396CrossRefGoogle ScholarPubMed
10.Slater, E, Shields, J. Psychotic and neurotic illness in twins (Medical Research Council Special Report Series No. 278. London: Her Majesty's Stationery Office, 1953Google ScholarPubMed
11.Inouye, E. Similarity and dissimilarity of schizophrenia in twins. Proceedings of the 3rd World Congress of Psychiatry, 1961; 1: 524530Google Scholar
12.Kendler, KS. Overview: a current perspective on twin studies of schizophrenia. Am J Psychiatry 1983; 140: 14131425Google ScholarPubMed
13.Cannon, TD, Kaprio, J, Lonnqvist, J, Huttunen, M, Koskenvuo, M. The genetic epidemiology of schizophrenia in a Finnish twin cohort: a population-based modelling study. Arch Gen Psychiatry 1984; 41: 541545Google Scholar
14.McGuffin, P, Asherson, P, Owen, M, Farmer, A. The strength of the genetic effect: is there room for an environmental influence in the aetiology of schizophrenia. Br J Psychiatry 1994; 16: 593599CrossRefGoogle Scholar
15.Farmer, AE, McGuffin, P, Gottesman, II. Twin concordance for DSM-III schizophrenia: scrutinizing the validity of the definition. Arch Gen Psychiatry 1987; 44: 634641CrossRefGoogle ScholarPubMed
16.McGuffin, P, Farmer, AE, Gottesman, II, Murray, RM, Reveley, AM. Twin concordance for operationally defined schizophrenia: confirmation of familiality and heritability. Arch Gen Psychiatry 1984; 41: 541555CrossRefGoogle ScholarPubMed
17.Cardno, AG, Marshall, EJ, Coid, Bet al.Heritability estimates for psychotic disorders: the Maudsley twin psychosis series. Arch Gen Psychiatry 1999; 56: 162168CrossRefGoogle ScholarPubMed
18.Mowry, BJ, Nancarow, DJ. Molecular Genetics of Schizophrenia. Clin Exp Pharmacology and Physiology 2001; 28: 6669CrossRefGoogle ScholarPubMed
19.Mortensen, PB, Pedersen, CB, Westergaard, T, Wohlahrt, J, Ewald, H, Mors, O, Andersen, PK, Melbye, M. Effects of family history and place and season of birth on the risk of schizophrenia. New Eng J Med 1999; 340: 603608CrossRefGoogle ScholarPubMed
20.Kendler, KS. Twin studies of psychiatric illness. Arch Gen Psych 2001; 58: 10051014CrossRefGoogle ScholarPubMed
21.Portin, P, Alanen, YO. A critical review of genetic studies of schizophrenia. II. Molecular genetic studies. Acta Psychiatrica Scand 1997; 95: 7380CrossRefGoogle ScholarPubMed
22.Mowry, BJ, Nancarrow, DJ, Levinson, DF. The molecular genetics of schizophrenia: an update. Aust NZ J Psychiatry 1997; 31: 704713CrossRefGoogle ScholarPubMed
23.Lichterman, D, Karbe, E, Maier, W. The genetic edipemiology of schizophrenia and of schizophrenia spectrum disorders. Eur Arch Psychiatry and Clin Neuroscience 2000; 250:304310CrossRefGoogle Scholar
24.Straub, RE, Jiang, Y, MacLean, CJet al.Genetic variation in the 6p22.3 gene DTNBP1, the human ortholog of the mouse dysbindin gene, is associated with schizophrenia. Am J Human Genetics 2002; 71: 337348CrossRefGoogle ScholarPubMed
25.Schwab, SG, Knapp, M, Mondabon, Set al.Support for association of schizophrenia with genetic variation in the 6p22.3 gene, dysbindin, in sib-pair families with linkage and in an additional sample of triad families. Am J Human Genetics 2003; 72: 185190CrossRefGoogle Scholar
26.Williams, NM, Preece, A, Morris, DWet al.Identification in 2 independent samples of a novel schizophrenia risk haplotype of the dystrobrevin binding protein gene (DTNBP1). Arch Gen Psychiatry 2004; 61: 336–44CrossRefGoogle ScholarPubMed
27.Kendler, KS. Schizophrenia genetics and dysbindin: a corner turned? Am J Psychiatry 2004; 161:15331536CrossRefGoogle ScholarPubMed
28.Harrison, PJ, Weinberger, DR. Schizophrenia genes, gene expression, and neuropathology: on the matter of their convergence. Molecular Psychiatry 2005; 10: 4068CrossRefGoogle ScholarPubMed
29.Mata, I, Sham, PC, Gilvarry, CM, Jones, PB, Lewis, SW, Murray, RM. Childhood schizotypy and positive symptoms in schizophrenic patients predict schizotypy in relatives. Schizophrenia Res 2000; 44: 129136CrossRefGoogle ScholarPubMed
30.Lane, A, Kinsella, A, Murphy, Pet al.The Anthropometric assessment of dysmorphic features in schizophrenia as an index of its developmental origins. Psychological Med 1997; 27: 1155–64CrossRefGoogle ScholarPubMed
31.DeLisi, LE. Defining the course of brain structural change and plasticity in schizophrenia. Psychiatry Res 1999; 92: 19CrossRefGoogle ScholarPubMed
32.Cannon, M, Byrne, M, Cotter, D, Sham, P, Larkin, C, O'Callaghan, E. Further evidence for anomalies in the hand-prints of patients with schizophrenia: a study of secondary creases. Schizophrenia Res 1994; 13: 179184CrossRefGoogle ScholarPubMed
33.Blackwood, DH, Fordyce, A, Walker, MT, St Clair, DM, Porteous, DJ, Muir, WJ. Schizophrenia and affective disorders — cosegregation with a translocation at chromosome 1q42 that directly disturbs brain-expressed genes: clinical and P300 findings in a family. Am J Human Genetics 2001; 69: 428433CrossRefGoogle Scholar
34.Cardno, AG, Rijsdijk, FV, Sham, PC, Murray, RM, McGuffin, P. A twin study of genetic relationships between psychotic symptoms. American Journal of Psychiatry 2002; 159:539545CrossRefGoogle ScholarPubMed
35.Book, JA. Schizophrenia as a gene mutation. Acta Genetica 1953; 4:133139Google ScholarPubMed
36.Lewis, A. Fertility and mental illness. The Eugenics Review 1958; 50: 91106Google ScholarPubMed
37.Huxley, J, Mayr, E, Osmond, H, Hoffer, A. Schizophrenia as a genetic morphism. Nature 1964;204:2221CrossRefGoogle ScholarPubMed
38.Johnason, E. A study of schizophrenia in the male. Acta Psychiatrica Scandinavica 1958 (suppl 125): 33Google Scholar
39.Gregory, I. An analysis of family data on 1000 patients admitted to a Canadian mental hospital. Acta Genetica Statistica Medicina 1959; 9: 5496Google ScholarPubMed
40.Bojanovsky, J, Gerylovova, A. The relation of schizophrenia to the age of parents of the patient. Nervenartz 1967; 38: 4042Google Scholar
41.Hare, EH, Moran, PA. Raised paternal age in psychiatric patients: evidence for the constitutional hypothesis. Br J Psychiatry 1979; 134: 169177CrossRefGoogle ScholarPubMed
42.Kinnell, HG. Parental age in schizophrenia. Br J Psychiatry 1983; 142: 204CrossRefGoogle ScholarPubMed
43.Malaspina, D, Harlap, S, Fennig, S, Heiman, D, Nahon, D, Feldman, D, Susser, ES. Advancing paternal age and the risk of schizophrenia. Arch Gen Psychiatry 2001; 58:361367CrossRefGoogle ScholarPubMed
44.Crow, JF. The high spontaneous mutation rate: is it a health risk? Proceedings of the National Academy of Science, USA 1997; 94: 83808386CrossRefGoogle ScholarPubMed
45.Zhang, Y, Kreger, BE, Dorgan, JFet al.Parental age at child's birth and son's risk of prostate cancer. Am J Epidemiology 1999; 150: 12081212CrossRefGoogle ScholarPubMed
46.Hemminki, K, Kyyronen, P. Parental age and risk of sporadic and familial cancer in offspring: implications for germ cell mutagenesis. Epidemiology 1999; 10: 747751CrossRefGoogle ScholarPubMed
47.Mcintosh, GC, Olshan, AF, Baird, PA. Paternal age the the risk of birth defects in offspring. Epidemiology 1995; 6: 282288CrossRefGoogle ScholarPubMed
48.Orr, HT. Unstable trinucleotide repeats and the diagnosis of neurodegenerative disease. Human Pathology 1994; 25: 598601CrossRefGoogle ScholarPubMed
49.Johnson, JE, Cleary, J, Ahsan, Het al.Anticipation in schizophrenia: biology or bias? Am J Med Genetics 1997; 74:2752803.0.CO;2-P>CrossRefGoogle ScholarPubMed
50.Husted, J, Scutt, LE, Bassett, AS. Paternal transmission and anticipation in schizophrenia. Am J Medical Genetics 1998; 81: 1561623.0.CO;2-U>CrossRefGoogle ScholarPubMed
51.Lin, CH, Tsai, SJ, Yu, YW, Yang, KH, Hsu, CP, Hong, CJ. Study of anticipation in Chinese families with schizophrenia. Psychiatry and Clin Neurosciences 2001; 2: 137140CrossRefGoogle Scholar
52. American College of Medical Genetics. Statement on guidance for genetic counselling in advanced paternal age. Available at: http://www.faseb.org/genetics/acmg/pol-20.htm 2001Google Scholar
53.Fananas, L, Bertranpetit, J. Reproductive rates in families of schizophrenic patients in a case-control study. Acta Psychiatrica Scandinavica 1995; 91: 202204CrossRefGoogle ScholarPubMed
54.Lane, A, Byrne, M, Mulvany, F, Kinsella, A, Waddington, JL, Walsh, D, Larkin, C, O'Callaghan, E. Reproductive behaviour in schizophrenia relative to other mental disorders: evidence for increased fertility in men despite decreased marital rate. Acta Psychiatrica Scandinavica 1995; 91: 222228CrossRefGoogle ScholarPubMed
55.McGrath, JJ, Hearle, J, Jenner, L, Plant, K, Drummond, A, Barkla, JM. The fertility and fecundity of patients with psychoses. Acta Psychiatrica Scandinavica 1999; 99: 441446CrossRefGoogle ScholarPubMed
56.Craddock, N, Jones, I. Molecular genetics of bipolar disorder. Br J Psychiatry 2001;41(suppl):128133CrossRefGoogle ScholarPubMed
57.Bramon, E, Sham, PC. The common genetic liability between schizophrenia and bipolar disorder: a review. Current Psychiatry Reports 2001; 3: 332337CrossRefGoogle ScholarPubMed
58.Berrettini, WH. Are schizophrenic and bipolar disorders related? A review of family and molecular studies. Biological Psychiatry 2000; 48: 531538CrossRefGoogle ScholarPubMed
59.Berrettini, WH. Molecular linkage studies of bipolar disorders. Bipolar Disorders 2001; 3: 276283CrossRefGoogle ScholarPubMed
60.Cotter, D, Pariante, CM. Stress and the progression of the developmental hypothesis of schizophrenia. Br J Psychiatry 2002; 181: 363365CrossRefGoogle ScholarPubMed
61.Baumann, B, Bogerts, B. The pathomorphology of schizophrenia and mood disorders: similarities and differences. Schizophrenia Res 1999; 39: 141148CrossRefGoogle ScholarPubMed
62.Johnstone, EC, Cooling, NJ, Frith, CD, Crow, TJ, Owens, DG. Phenomenology of organic and functional psychoses and the overlap between them. Br J Psychiatry 1988; 153:770776CrossRefGoogle ScholarPubMed
63.Tanenberg-Karant, M, Fennig, S, Ram, R, Krishna, J, Jandorf, L, Bromet, EJ. Bizarre delusions and first rank symptoms in a first-admission sample: a preliminary analysis of prevalence and correlates. Comprehensive Psychiatry 1995; 36: 428434CrossRefGoogle Scholar
64.Post, RM. Comparative pharmacology of bipolar disorder and schizophrenia. Schizophrenia Research 1999; 39: 153158CrossRefGoogle ScholarPubMed
65.Benabarre, A, Vieta, E, Colom, F, Martinez-Aran, A, Reinares, M, Gasto, C. Bipolar disorder, schizoaffective disorder and schizophrenia: epidemiologic, clinical and prognostic differences. European Psychiatry 2001; 16: 167172CrossRefGoogle ScholarPubMed
66.Moorey, S, Williams, R. Psychotherapy. In: Murray, R, Hill, P, McGuffin, P (eds), The Essentials of Postgraduate Psychiatry (Third Edition). Cambridge: Cambridge University Press 1997Google Scholar
67.Beck, AT. Cognitive Therapy and the Emotional Disorders. New York: International Universities Press, 1976Google Scholar
68.Tarrier, N, Harwood, S, Yusupoff, L, Beckett, R, Baker, A. Coping strategy enhancement: a method of treating residual psychotic symptoms. Behavioural Psychotherapy 1990; 18: 283293CrossRefGoogle Scholar
69.Kingdon, DG, Turkington, D. Cognitive Behaviour Therapy of Schizophrenia. Hove: Lawrence Erlbaum, 1994CrossRefGoogle ScholarPubMed
70.Kelly, BD, Feeney, L. A beautiful mind. Ir J Medical Sci 2002; 171: 170CrossRefGoogle ScholarPubMed
71.McNally, SE, Goldberg, JO. Natural cognitive coping strategies in schizophrenia. Br J Medical Psychology 1997; 70: 159167CrossRefGoogle ScholarPubMed
72.Bradshaw, W. Integrating cognitive-behavioral psychotherapy for persons with schizophrenia into a psychiatric rehabilitation program: results of a three year trial. Community Mental Health J 2000; 36: 491500.CrossRefGoogle ScholarPubMed
73.Turkington, D, Kingdon, D, Turner, T. Insight into Schizophrenia Research Group. Effectiveness of a brief cognitive-behavioural therapy intervention in the treatment of schizophrenia. Br J Psychiatry 2002; 180: 523527CrossRefGoogle ScholarPubMed
74.Lewis, S, Tarrier, N, Haddock, Get al.Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: acute-phase outcomes. British Journal of Psychiatry Suppl. 2002; 43: s9197CrossRefGoogle ScholarPubMed
75.Rector, NA, Seeman, MV, Segal, ZV. Cognitive therapy for schizophrenia: a preliminary randomized controlled trial. Schizophrenia Research 2003; 63: 111CrossRefGoogle ScholarPubMed
76.Turkington, D, Dudley, R, Warman, DM, Beck, AT. Cognitive-behavioral therapy for schizophrenia: a review. J Psychiatric Practice 2004; 10: 516.CrossRefGoogle ScholarPubMed
77.Wiersma, D, Jenner, JA, van de Willige, G, Spakman, M, Nienhuis, FJ. Cognitive behaviour therapy with coping training for persistent auditory hallucinations in schizophrenia: a naturalistic follow-up study of the durability of effects. Acta Psychiatr Scandinavica 2001; 103: 393399CrossRefGoogle ScholarPubMed
78.Tarrier, N, Lewis, S, Haddock, Get al.Cognitive-behavioural therapy in first-episode and early schizophrenia. 18-month follow-up of a randomised controlled trial. Br J Psychiatry 2004; 184: 231239CrossRefGoogle ScholarPubMed
79.Tarrier, N, Kinney, C, McCarthy, E, Humphreys, L, Wittkowski, A, Morris, J. Two-year follow-up of cognitive-behavioral therapy and supportive counseling in the treatment of persistent symptoms in chronic schizophrenia. J Consulting and Clinical Psychology 2000; 68: 917922.CrossRefGoogle ScholarPubMed
80.Pilling, S, Bebbington, P, Kuipers, E, Garety, P, Geddes, J, Orbach, G, Morgan, C. Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychological Med 2002; 32: 763782CrossRefGoogle ScholarPubMed
81.Yung, A, Phillips, L, McGorry, PD. Treating Schizophrenia in the Prodromal Phase. London: Taylor & Francis, 2004CrossRefGoogle Scholar
82.Jones, C, Cormac, I, Silveira da, MN, Campbell, C. Cognitive behaviour therapy for schizophrenia. Cochrane Database of Systematic Reviews 2004; 18: CD000524Google Scholar
83.Clarke, M, O'Callaghan, E. Is earlier better? At the beginning of schizophrenia: timing and opportunities for early intervention. Psychiatric Clinics of North America 2003; 26: 6583CrossRefGoogle ScholarPubMed
84.McGorry, PD, Yung, AR, Phillips, U. The ‘close-in’ or ultra high risk model: A safe and effective strategy for research and clinical intervention in prepsychotic mental disorder. Schizophrenia Bull 2003; 29: 771790.CrossRefGoogle ScholarPubMed
85.Schaffner, KF, McGorry, PD. Preventing severe mental illnesses – new prospects and ethical challenges. Schizophrenia Res 2001; 51: 315CrossRefGoogle ScholarPubMed
86.McGorry, PD, Yung, AR, Phillips, LJet al.Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Arch Gen Psychiatry 2002; 59: 921928CrossRefGoogle Scholar
87.Cornblatt, B, Lencz, T, Obuchowski, M. The schizophrenia prodrome: treatment and high-risk perspectives. Schizophrenia Res 2002; 54: 177186CrossRefGoogle ScholarPubMed
88.Marshall, M, Lockwood, A. Early Intervention for psychosis. Cochrane Database Systematic Review 2004; 2: CD004718Google Scholar